Hi, I'm Cliff Ruddle
and I'm really happy to be with you today
and spend a little bit of time learning more about endodontics together.
I'm really enthusiastic to speak with you
a little bit today about
the new WaveOne® Gold. I say 'new' because it has replaced
WaveOne®, its predecessor.
Notice that we have
different colors on the handle
corresponding to the ISO D0 tip diameters.
We also can see at the bottom slide
the tapers with the files
associated with their terminal extent.
And then, of course, the main nomenclature to bring your attention to
is that we speak of the small, primary, medium, and large files.
Primary is used because it is always,
virtually always, the first file that's used in any particular case,
whether it's an anterior or posterior tooth.
I'll talk to you a little bit later
when we might use either the small, or the medium, or the large.
But primary is the first file used.
With experience sometimes and based on a preoperative film
that reveals a large system,
one might, after a glide path, select the medium file, for example,
but generally I want to come back and keep repeating
it's the primary file that's usually the first file
into any particular system.
So let's talk a little bit about why
one might need another file, either smaller or larger.
in the range of anatomical cases that we see on a daily basis.
The assumption here is we have a smooth,
reproducible glide path and the canal has been secured.
So in this instance,
we can carry the primary file down the canal like we've just talked about.
But what if it really won't advance?
What if it really won't move
so that the rubber stop goes down on the selected reference point,
which would suggest the file's at length?
Well, in those instances,
we can go to the small.
Because the small has a tip of only
two hundredths of a millimeter, it's a 20,
then it will easily crawl along the glide path
and carve its shape to length.
Now what's important here is there is a
yellow EndoActivator® tip that can go into these smaller shapes
to agitate effectively.
Also it's important to note that there is a matching
master cone that fits the yellow file.
And so you could use this as a standalone
only file that achieves length,
especially when the roots are narrow and long.
That might be the single sole file that's taken to length.
On the other hand you can think of it as a bridge file.
Because if you have more root bulk and form,
then you can use this bridge file
to get back to the primary
and this time the primary will go to length.
Okay,
what if the primary file
goes to length easily, you withdraw it,
there's no debris on its flutes,
you grab a 25/.02
nickel titanium gauging file
and it also is loose at length?
That just simply means to the clinician
the terminus of the canal is larger than the file.
So in these instances,
we would go up to the medium -
- that's a 35/.06. So the tip - the D0 diameter is 35
and it's taper is 6%.
And again when that file comes out
you're looking for debris on its apical flutes.
Alternatively, you can gauge with a
nickel titanium 35/.02.
But remember when we start to get up over a size 30,
even in the world of nickel titanium,
the instances become a little bit stiff.
So in these instances I would rather you gauge with a smooth,
flexible matching gutta-percha cone
from Dentsply Sirona.
That's those new cones I was speaking about that have
superior sizing and formulation,
and slide it in. And if it gets to length,
well, then you can pretty much be certain that that's the terminal diameter.
And you would use this method
on and so forth,
to see if you want to go to the large or not
in those instances where there is a
big system with a big apical diameter.
Until next time, great success.